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1.
Ophthalmology ; 129(10): 1087-1095, 2022 10.
Artigo em Inglês | MEDLINE | ID: mdl-35643168

RESUMO

PURPOSE: To assess the association between BNT162b2 mRNA coronavirus disease 2019 (COVID-19) vaccine and the risk of active noninfectious uveitis (NIU). DESIGN: Retrospective, population-based study. PARTICIPANTS: Two million six hundred two thousand five hundred fifty-seven people who received the first vaccine dose between December 20, 2020, and April 30, 2021, and 2 441 719 people who received the second vaccine dose between January 10, 2021, and April 30, 2021. METHODS: Events of active NIU were included if they occurred within 21 days after either vaccine dose. Active NIU was defined as newly active or worsening ocular inflammation requiring initiation or increase in local or systemic corticosteroids. Observed cases were compared with the expected number, based on the experience of the population in 2019. MAIN OUTCOME MEASURES: Age- and sex-adjusted standardized incidence ratios (SIRs) and attributable risks after BNT126b2 vaccination. RESULTS: Overall, 100 and 88 events of active NIU were recorded within 21 days after the first and second vaccine doses, respectively. Using the experience of the population in 2019 as a reference, after the first dose, the estimated age- and sex-adjusted SIR was 1.41 (95% confidence interval [CI], 1.15-1.71) along with a 21-day attributable risk of 1.12 cases per 100 000 vaccinees. After the second dose, the SIR was 1.31 (95% CI, 1.05-1.62), with an estimated attributable risk of 0.86 cases per 100 000 vaccinees. Anterior uveitis was the most common site of inflammation, occurring in 90.96% of eyes, and idiopathic uveitis was the most common cause (56.38%). CONCLUSIONS: This study suggests that the BNT162b2 mRNA COVID-19 vaccine may be associated with an increased risk of active NIU. However, considering the small effect size and study limitations, this study does not provide proof for a cause-and-effect relationship. The small estimated attributable risks suggest that the impact on public health is relatively minor.


Assuntos
Vacina BNT162 , COVID-19 , Uveíte , Corticosteroides , Vacina BNT162/efeitos adversos , COVID-19/epidemiologia , COVID-19/prevenção & controle , Vacinas contra COVID-19/efeitos adversos , Humanos , Inflamação , RNA Mensageiro , Estudos Retrospectivos , Uveíte/epidemiologia , Uveíte/etiologia
2.
J Matern Fetal Neonatal Med ; 35(25): 4961-4968, 2022 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-34289790

RESUMO

PURPOSE: To assess the impact of post-thawing embryo culture on frozen embryo transfer (FET) outcomes. METHODS: A retrospective cohort study including 678 consecutive FET cycles performed between the years 2004 and 2017 was conducted. Patients older than 45 years old were excluded. FET cycles were stratified as follows: (1) two-day (2d) embryos thawed and cultured to three-day (3d) versus 3d embryos thawed and transferred; (2) 2d or 3d embryos thawed and cultured to blastocysts versus blastocysts thawed and transferred. A p-value <.05 was considered statistically significant. RESULTS: Maternal age, BMI, smoking, and basal FSH of the 2d and 3d cultured embryo group (n = 110) and the 3d non-cultured embryo group (n = 189) were comparable. Endometrium preparation protocols and the achieved endometrial thickness did not differ between groups. Pregnancy rate, implantation rate, clinical pregnancy, live birth rate, abortions, multiple pregnancies, perinatal outcomes, and birth weight were comparable.The 2d and 3d embryos cultured to blastocyst (n = 41) compared to non-cultured blastocyst (n = 338) showed that the non-cultured blastocyst patients had higher smoking rates and longer follicular phase. Endometrial thickness was comparable. The 2d and 3d embryos cultured to blastocyst stage had higher multiple pregnancies rate compared to the blastocyst non-cultured group, whereas pregnancy rate, implantation rate, live birth rate, miscarriages, perinatal outcomes, and birth weight were comparable. CONCLUSION: We could not demonstrate that the post-thaw culture had a significant impact on the outcome of FET cycles.


Assuntos
Aborto Espontâneo , Criopreservação , Gravidez , Feminino , Humanos , Pessoa de Meia-Idade , Estudos Retrospectivos , Peso ao Nascer , Criopreservação/métodos , Transferência Embrionária/métodos , Taxa de Gravidez , Implantação do Embrião
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